Polymorphous low-grade adenocarcinoma: Difference between revisions

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{{Infobox medical condition (new)
{{Short description|A type of salivary gland cancer}}
| name            = Polymorphous low-grade adenocarcinoma
{{Medical resources}}
| image          = Polymorphous low-grade adenocarcinoma - very low mag.jpg
| caption        = Low magnification [[micrograph]] of a polymorphous low-grade adenocarcinoma, showing the typical variation of architectural arrangement. [[H&E stain]].
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'''Polymorphous low-grade adenocarcinoma''' ('''PLGA''') is a rare, asymptomatic, slow-growing [[malignant]] [[salivary gland]] [[tumor]].<ref name=pmid19136798>{{cite journal |vauthors=Arathi N, Bage AM |title=Polymorphous low-grade adenocarcinoma of parotid gland: a rare occurrence |journal=Indian J Pathol Microbiol |volume=52 |issue=1 |pages=103–5 |year=2009 |pmid=19136798 |doi= 10.4103/0377-4929.44985|url=}}</ref> It is most commonly found in the [[palate]].<ref name=pmid18327037>{{cite journal |vauthors=Paleri V, Robinson M, Bradley P |title=Polymorphous low-grade adenocarcinoma of the head and neck |journal=Curr Opin Otolaryngol Head Neck Surg |volume=16 |issue=2 |pages=163–9 |date=April 2008 |pmid=18327037 |doi=10.1097/MOO.0b013e3282f70441 |url=}}</ref>


The name of the tumor derives from the fact that:
'''Polymorphous low-grade adenocarcinoma''' (PLGA) is a rare type of [[salivary gland]] [[cancer]] that is characterized by its slow growth and low potential for metastasis. It primarily affects the minor salivary glands, particularly in the [[oral cavity]].
*It has a varied microscopic architectural appearance, i.e. it is ''polymorphous''.
*It is non-aggressive when compared to other oral cavity tumors, i.e. it is a ''low-grade'' tumor.<ref name="pmid19136798"/>
*It forms glands, i.e. it is an ''[[adenocarcinoma]]''.
It affects the minor salivary glands in the area between the hard and the soft palate. Male to female ratio is 3:1, and the average age is 56 years.


==Histology==
==Presentation==
PLGAs consist of a monomorphous cell population that has a varied histologic morphology.
PLGA typically presents as a painless, slow-growing mass in the oral cavity. It most commonly occurs in the [[palate]], but can also be found in other areas such as the [[buccal mucosa]], [[upper lip]], and [[retromolar area]]. Patients may notice a firm, nodular swelling that is often asymptomatic until it reaches a significant size.


[[Microscope|Microscopically]], its [[histology]] can be confused with an [[adenoid cystic carcinoma]] and a [[pleomorphic adenoma]].
==Histopathology==
The histological appearance of PLGA is characterized by a diverse architectural pattern, which can include tubular, papillary, cribriform, and solid structures. The tumor cells are generally uniform with bland nuclear features, and the stroma is often fibrous. Despite its varied histological patterns, PLGA is distinguished by its low-grade cytological features and infiltrative growth pattern.


<gallery>
==Diagnosis==
Image:Polymorphous low-grade adenocarcinoma high mag.jpg|Polymorphous low-grade adenocarcinoma. [[H&E stain]].
Diagnosis of PLGA is primarily based on histopathological examination. A biopsy of the lesion is performed, and the tissue is examined under a microscope. Immunohistochemical staining can aid in differentiating PLGA from other salivary gland tumors, such as [[adenoid cystic carcinoma]] and [[mucoepidermoid carcinoma]].
Image:Polymorphous low-grade adenocarcinoma very high mag.jpg|[[Micrograph]] of a polymorphous low-grade adenocarcinoma. [[H&E stain]].
</gallery>


==Treatment==
==Treatment==
PLGAs are treated with wide local surgical excision and long-term follow-up.<ref name="pmid18327037"/>
The primary treatment for PLGA is surgical excision with clear margins. Due to its low-grade nature, PLGA has a good prognosis when completely excised. Recurrence is possible if the tumor is not fully removed, but metastasis is rare. In cases where surgical margins are positive or the tumor is in a location that makes complete excision difficult, [[radiation therapy]] may be considered.
There is a recurrence rate of 14% (Peterson, contemporary of oral and maxillofacial surgery).


==References==
==Prognosis==
{{reflist}}
The prognosis for patients with PLGA is generally favorable, with high survival rates. The risk of recurrence is low if the tumor is adequately excised. Long-term follow-up is recommended to monitor for any signs of recurrence.


== External links ==
==Related pages==
{{Medical resources
* [[Salivary gland tumors]]
|  DiseasesDB    =
* [[Adenocarcinoma]]
|  ICD10          =
* [[Oral cancer]]
|  ICD9          =
* [[Histopathology]]
|  ICDO          =
|  OMIM          =
|  MedlinePlus    =
|  eMedicineSubj  =
|  eMedicineTopic =
|  MeshID        =
}}
 
{{Tumors of lip, oral cavity and pharynx}}


[[Category:Salivary gland neoplasia]]
[[Category:Salivary gland neoplasia]]
 
[[Category:Oral and maxillofacial pathology]]
{{neoplasm-stub}}
{{dictionary-stub1}}

Revision as of 19:16, 22 March 2025

A type of salivary gland cancer



Polymorphous low-grade adenocarcinoma (PLGA) is a rare type of salivary gland cancer that is characterized by its slow growth and low potential for metastasis. It primarily affects the minor salivary glands, particularly in the oral cavity.

Presentation

PLGA typically presents as a painless, slow-growing mass in the oral cavity. It most commonly occurs in the palate, but can also be found in other areas such as the buccal mucosa, upper lip, and retromolar area. Patients may notice a firm, nodular swelling that is often asymptomatic until it reaches a significant size.

Histopathology

The histological appearance of PLGA is characterized by a diverse architectural pattern, which can include tubular, papillary, cribriform, and solid structures. The tumor cells are generally uniform with bland nuclear features, and the stroma is often fibrous. Despite its varied histological patterns, PLGA is distinguished by its low-grade cytological features and infiltrative growth pattern.

Diagnosis

Diagnosis of PLGA is primarily based on histopathological examination. A biopsy of the lesion is performed, and the tissue is examined under a microscope. Immunohistochemical staining can aid in differentiating PLGA from other salivary gland tumors, such as adenoid cystic carcinoma and mucoepidermoid carcinoma.

Treatment

The primary treatment for PLGA is surgical excision with clear margins. Due to its low-grade nature, PLGA has a good prognosis when completely excised. Recurrence is possible if the tumor is not fully removed, but metastasis is rare. In cases where surgical margins are positive or the tumor is in a location that makes complete excision difficult, radiation therapy may be considered.

Prognosis

The prognosis for patients with PLGA is generally favorable, with high survival rates. The risk of recurrence is low if the tumor is adequately excised. Long-term follow-up is recommended to monitor for any signs of recurrence.

Related pages